The National Cancer Advisory Board of the Institute of Medicine with the National Research Council have called for physician education in palliative care. The Education in Palliative and End-of-life Care (EPEC) Project is a high-impact, high-dissemination, train-the-trainer program that aims to reach all physicians in the US with education about palliative care. Funding from the Robert Wood Johnson Foundation for its establishment permitted the development of the EPEC Curriculum, trainer instructions, multiple approaches to teaching, - 600 slides, and trigger tapes. The website, makes all materials available to anyone and has a web-based version of the curriculum (www.epec.net). The EPEC Project accepts competitive applications to become EPEC Trainers. After they complete the 2-1/2 day 'Become an EPEC Trainer'Conference, the EPEC Trainers are certified to use the curriculum to reach others. The EPEC Project provides continuing support and further training as they pursue their plans. The EPEC Project also forms the basis for collaborations with specialty societies as well with healthcare delivery organizations in which EPEC teaching is adapted and implemented. Independent data gathered by the Sutton Group indicate that the EPEC Project has the potential to reach its goal if its efforts are sustained. We propose to continue the project by: 1. Disseminating palliative care competence using our curriculum-driven, train-the-trainer model. 2. Developing a curriculum driven faculty development approach for 'Faculty Development'conferences to enhance and sustain the teaching and leadership skills of EPEC Trainers. 3. Engaging a systematic review process that incorporates principles of best evidence medicine and best evidence medical education, resulting in successive up-to date editions of the curriculum until the final one in 2008. 4. Evaluating the impact of the 'Become an EPEC Trainer'and 'Faculty Development'Conferences. At the conclusion of the project we anticipate achievement these goals and transition to a steady-state, self-sustaining, partnership approach to EPEC training.